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Stroke

Brain Attack/Stroke Treatments

There are various ways of treating brain attack, or stroke, depending on the location and severity of the attack.

tPA,or tissue plasminogen activator- It's now more likely than ever that patients suffering the most common form of brain attack can be successfully treated and restored to pre-stroke condition without permanent disability. But that's only if their condition is recognized as a medical emergency and the proper treatment is delivered as quickly as possible. Treatment should be given within three hours of the attack symptoms, and the faster the better. Other treatments might be available beyond three hours depending on specific characteristics of the stroke.

The drug, tPA, which stands for "tissue plasminogen activator," is the most important treatment option available today for potentially reversing the damage caused by brain attack. Since tPA works by breaking up clots, it's only effective against ischemic strokes- those brain attacks caused by blood clots blocking arteries. It's not effective against hemorrhagic strokes, those caused by bleeding into the brain.

The standard method of administering tPA is through an intravenous line. The drug is infused through the veins, and breaks up the clot, allowing blood to flow in that area of the brain again. If given within the first three hours following the onset of symptoms, or better yet, faster, -tPA can significantly improve the patient's outcome over the long term.

Newer treatments are currently being studied. One new innovation is to administer tPA through a catheter, sending the drug directly to the point of clotting for even faster action. Another is to take specialized catheters up to the clot that can pull it out or break it up with an ultrasound. Experts hope that these methods will lead to better recoveries after bigger strokes, and possibly be able to reverse the damage longer after the attack.

Whichever method is used, it's important to remember that time is of the essence. The sooner the drug therapy begins, the better the chances for full recovery. In other words, patients who receive tPA therapy within the first hour have better recovery rates than those who receive treatment after three hours.

It's also important to remember that tPA isn't given to patients as soon as they're wheeled into the emergency room. First, brain scans and other tests must be given to see if brain attack is, in fact, the proper diagnosis, and to pinpoint the location and type of attack.

IT'S IDEAL THAT A PATIENT BE RECEIVED IN AN EMERGENCY ROOM WITHIN ONE HOUR OR LESS OF FIRST EXPERIENCING SYMPTOMS. DON'T HESITATE TO CALL 911 IF YOU THINK YOU OR A LOVED ONE IS IN THE MIDST OF A BRAIN ATTACK. IT IS BETTER TO BE SAFE THAN SORRY.

Surgery- Those who suffer a hemorrhagic stroke, due to bleeding in or around the brain from a ruptured blood vessel such as an aneurysm, should quickly undergo surgery to repair the damaged artery and stop the bleeding. Sometimes, if an ischemic or hemorrhagic stroke is big, surgery might also be an option to help relieve dangerous swelling in the brain.

Rehabilitation After Brain Attack

If you or a love one has experienced the physical and emotional trauma of a brain attack, or stroke, and the damage can't be immediately reversed, rehabilitation is the next step toward partial or complete recovery. The goal is for patients to learn how to regain as many of their pre-attack abilities as possible.

The process is most often undertaken in an inpatient rehabilitation hospital or section of a hospital, or at a nursing facility. Depending on the damage caused by the brain attack, one or more of the following therapies might be provided.

After routine rehabilitation, some patients might be able to participate in rehabilitation clinical trials studying new ways of improving recovery.

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This article is a NetWellness exclusive.

Last Reviewed: Oct 12, 2007

Pooja  Khatri, MD Pooja Khatri, MD
Associate Professor of Neurology
College of Medicine
University of Cincinnati

Joseph P Broderick, MD Joseph P Broderick, MD
Professor and Chair of Neurology
College of Medicine
University of Cincinnati

Dennis   Landis, MD Dennis Landis, MD
Formerly, Professor of Neurology
School of Medicine
Case Western Reserve University